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[目的]观察健脾益肾活血方联合西药治疗糖尿病肾病疗效。[方法]使用随机平行对照方法,将56例住院患者按掷骰子法简单随机分为两组。对照组28例加缬沙坦胶囊,80mg/次,1次/d;服用降糖药物/注射胰岛素,合理饮食、适量运动。治疗组28例健脾益肾活血方(水蛭粉1g,丹参、党参、川芎各15g,黄芪20g,玄参、甘草炙、白术、赤芍各10g;肾阳虚加葫芦巴、仙灵脾;阴虚燥热加生地、丹皮与知母;瘀血严重加大黄、泽兰叶、红花、桃仁;水肿严重加泽泻、车前子、猪苓;痰浊内阻,恶心呕吐加温胆汤),1剂/d,水煎300mL,3次/d;西药治疗同对照组。连续治疗30d为1疗程。观测临床症状、临床症状积分(UAER、β2-GM、Scr、HbA1c)、不良反应。连续治疗3疗程,判定疗效。[结果]治疗组显效17例,有效8例,无效3例,总有效率89.29%。对照组显效13例,有效7例,无效7例,总有效率75.00%。治疗组疗效优于对照组(P<0.05)。相关指标两组均有改善(P<0.05),治疗组改善优于对照组(P<0.05)。[结论]健脾益肾活血方联合西药治疗糖尿病肾病疗效显著,值得推广。
[Objective] To observe the therapeutic effect of Jianpi Yishen Huoxue Recipe combined with western medicine on diabetic nephropathy. [Methods] Using randomized parallel control method, 56 inpatients were randomly divided into two groups randomly according to the dice method. Control group, 28 cases of valsartan capsules, 80mg / times, 1 time / d; taking hypoglycemic drugs / insulin injections, a reasonable diet, moderate exercise. Treatment group, 28 cases of spleen and kidney invigorating the blood side (leech powder 1g, Salvia, Codonopsis, Chuanxiong the 15g, Astragalus 20g, Scrophulariaceae, licorice Sunburn, Atractylodes, red peony root 10g; Yin and dry heat plus habitat, Dan and Anemarrhena; blood stained severely increased yellow, Zeeland leaves, safflower, peach; edema serious add Alisma, Plantago, Polyporus; phlegm resistance, nausea and vomiting warming gall Soup), 1 / d, decoction 300mL, 3 times / d; western medicine treatment with the control group. Continuous treatment of 30d for a course of treatment. The clinical symptoms, clinical symptom scores (UAER, β2-GM, Scr, HbA1c) and adverse reactions were observed. Continuous treatment of 3 courses to determine the efficacy. [Result] The treatment group was markedly effective in 17 cases, effective in 8 cases, ineffective in 3 cases, the total effective rate was 89.29%. The control group markedly effective in 13 cases, effective in 7 cases, 7 cases, the total effective rate was 75.00%. The treatment group was better than the control group (P <0.05). Related indicators improved in both groups (P <0.05), and the treatment group improved better than the control group (P <0.05). [Conclusion] The therapeutic effect of Jianpi Yishenhuoxue Recipe combined with western medicine on diabetic nephropathy is significant and worth promoting.